目的 探讨紫丹活血片联合硝苯地平治疗血管痉挛性心绞痛的临床疗效。方法 选择2019年6月—2021年6月开封市中心医院收治的180例血管痉挛性心绞痛患者，随机分为对照组和治疗组，每组各90例。对照组口服硝苯地平片，10 mg/次，3次/d。治疗组在对照组的基础上口服紫丹活血片，100 mg/次，3次/d。两组连续治疗15 d。观察两组患者临床疗效，比较治疗前后两组患者症状缓解时间，心绞痛发作次数和持续时间，血清因子白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶-9（MMP-9）和C反应蛋白（CRP）水平，及不良反应情况。结果 治疗后，治疗组临床有效率为98.89%，明显高于对照组的87.78%（P<0.05）。治疗后，治疗组症状缓解时间均明显早于对照组（P<0.05）。治疗后，两组心绞痛发作次数、持续时间均明显降低（P<0.05），且治疗组明显低于对照组（P<0.05）。治疗后，两组血清因子IL-6、TNF-α和CRP水平明显下降，而MMP-9水平明显升高（P<0.05），且治疗后治疗组血清因子水平明显好于对照组（P<0.05）。治疗组不良反应发生率明显低于对照组（5.56%vs 12.22%，P<0.05）。结论 紫丹活血片与硝苯地平联合治疗血管痉挛性心绞痛，明显提高临床疗效，症状得以有效改善，对心绞痛发作频次及血管炎性反应都有效降低。

Objective To explore the clinical effect of Zidan Huoxue Tablets combined with nifedipine in treatment of vasospasm angina pectoris. Methods Patients (180 cases) with vasospasm angina pectoris in Kaifeng Central Hospital from June 2019 to June 2021 were randomly divided into control and treatment group, and each group had 90 cases. Patients in the control group were po administered with Nifedipine Tablets, 10 mg/time, three times daily. Patients in the treatment group were po administered with Zidan Huoxue Tablets on the basis of the control group, 100 mg/time, three times daily. Patients in two groups were treated for 15 d. After treatment, the clinical evaluation was evaluated, the improvement time of symptom, the frequency and duration of angina pectoris, the levels of serum IL-6, TNF-α, MMP-9, and CRP and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 98.89%, which was significantly higher than 87.78% of the control group (P < 0.05). After treatment, the relief time of symptom in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the frequency and duration of angina pectoris in two groups were significantly decreased (P< 0.05), and which in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the levels of serum factors IL-6, TNF-α and CRP in the two groups were significantly decreased, while the level of MMP-9 were significantly increased (P < 0.05), and the level of serum factors in the treatment group was significantly better than that in the control group (P < 0.05). The adverse reaction rate in the treatment group was significantly lower than that in the control group (5.56% vs 12.22%, P < 0.05). Conclusion The combined treatment of Zidan Huoxue Tablets and nifedipine can enhances the efficacy, improves the symptoms, and effectively reduces the frequency of angina pectoris and vasculitis.

R972

河南省医学科技攻关计划项目（LHGJ20191170）